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TEMPLE CITY
79AS38A CE#BOf-1-61 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING Z
DEPARTNIENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY 7161-1171-0
JOHN A. LAMBIE, COUNTY ENGINEER NEAREST
WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST. re,�g
FOR APPLICANT TO FILL IN DISTRICT NO. GROUPFTYE P CESSED BY
i� ST _
BUILDING .-,��N C�` ��, STATISTICAL CLASSIFICATION SEWER MAP
ADDRES ( /C J BK PG
S
i CLASS. NO.,—DWELL. UNITS — —
LOT N(i/0-7- BLOCK WATER NOT REQUIRED RECEIVED
l ^ CERTIFICATE:
TRACT C
MAP �^� HIGHWAY STATE MAJOR SECOND, LOCAL
NO.OF LDGS. j NO: _L� (CIRCLE)
SIZE O LOT 2Q x I NOW ON LOT USE ZONE SPECIAL
USE OF CONDITIONS
EXISTING JBLDG.
/L C� vV/LLf- TT TEL.Gt �L� r
OWNER NO. O BUILDING SEXIST.
YARD HWY STREET NAME
ADDRESS f��ZC �2N ST / �"`�1 FRONTK WIDT
ARCHITECT
OR �� TEC.
L. P.L. •�
–ENGINEERS/1//i O
SIDE
P.L.
ADDRESS TEL. INSPECTION RECORD CL
CONTRACTOR NO. 0
ADDRESS
DESCRIPTION OF WORE a y O
LLI
CJ
NkIY ALTER REPAIR DEMOLISH ¢
f'
SQ. FT. / nNO.OF NO.OF
$IZE 2� STORIES FAMILIES
USEOF
pA-) �e 12 7
STRUCTURE C.
SIGNATURE O G
APPLICANT
VALUATION$, I -
APPROVALS DATE INSPECTOR'S SIGNATURE
P.C. PMT. ,1 FOUNDATION: LOCATION
FEE $ FEE $. FORMS.MATERIALS
- FRAME: FI RE STOPS, 1, !°"• - ,�,;
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING, BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, -
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH,INT.
TION OF THE LABOR C DE F THE STATE OF CALIFORNIAING TO
WORKMEN'S C P NSATIimgaf
LATH,EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERM
OR-
PERMITTEE RECT AND POSTED
ADDRESS
FINAL
CLYDE N. DIRLAM, PII(INCIPAL STRjJCTtjRAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERM VALIDATION aK M.O. CASH
,, ,1 2 �5 1 10 ,lUb
qq 4ow IL -
76A688ACE#80810-58 APPLICATION FOR BUILDING PERMIT 1
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
CROSS ST. G� -
CASSATT D. GRIFFIN, SUPT OF BUILDING
DIST RI T NO. GROUP TYPE P SSED BY
FOR APPLICANT TO FILL IN � CONST. f-GLS
[EXISTING
ILDING h' / STATISTICAL CLASSIFICATION SE ER MAP
DRESS 1 v/ —_A C, BK �
CLASS.NO.�DWELL.UNITS
T NO. �( BLOCK NUMABER Sj..IWYE YES O
ACT �°` USE ZONE SPECIAL
NO.OF.BLDGS CONDITIONS
ZE OF LOT NOW ON LOT � �L /
E OF
BLDG. BUILDING YARD HWY ST ET NAME EXIST.
SETBACK WIDTH
OWNER MAIL /' ,ry AA� + FRONT
ADDRESS` ! �/ CN SIDE y� V
TEL. P.L.
CITY No. INSPECTION RECORD
ARCHITECT OR TEL.
ENGINEER NO.
ADDRESS
CONTRACTOR
ADDRESSs Q% �whly
DESCRIPTION OF WORK
NEW ADD ALTER REPAIR DEMOLISH
SQ.FT. NO.OF NO.OF
SIZE STORIES FAMILIES
USE �/
STRUCTURE /
SIGNATURE OF
APPLICANT APPROVALS DATE INSPECTOR'S SIGNATURE
ADDRESS 9 FOUNDATION:LOCATION .i
_FORMS,MATERIALS /o--r -� S
VALUATION$ '" FRAME:FIRE STOPS.
BRACING,BOLTS
P.C. PMT. G�_ FURNACE:LOCATION.
FEE $ I FEE $ GAS VENT,DUCTS
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH.INT.
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS R L G BUILDING CONSTRUCTION. LATH.EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTE RECT AND POSTED
ADDRESS " FINAL ° rt- Fl—
CLYDE
'""lCLYDE N. DIRLAM, PRINCIPAL STRJJC7RAL ENGINEER
CK. .
PLAN CHECK VALIDATION CK. M.O. CASH' PEBNIIT VALIDATION M.O. CASH
L_APo- L �; OCT 2 1 9.0 0 *0,